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Clarithromycin-resistant H pylori detected in children by stool PCR

The most recent issue of Helicobacter investigates the detection of clarithromycin-resistant H pylori by stool PCR in children.

News image

Helicobacter pylori infection is acquired mainly during childhood.

To eradicate Helicobacter pylori, clarithromycin-based triple therapy has been recommended in children and adults by the latest Maastricht Consensus.

The prevalence of clarithromycin-resistant Helicobacter pylori was higher in children than that in adults.

Therefore, rapid, reliable and noninvasive methods for detecting clarithromycin-resistant Helicobacter pylori strains should be developed for children.

Dr Li jing Xiong and colleagues reviewed studies on evaluating stool PCR in detecting clarithromycin-resistant Helicobacter pylori and epidemiological surveys of the prevalence of clarithromycin-resistant Helicobacter pylori in children.

The average rates of primary clarithromycin-resistant Helicobacter pylori ranged from less than 10% to more than 40% in different regions.

Stool PCR showed perfect specificity in detection of clarithromycin-resistant H pylori in children
Helicobacter

The team of doctors assessed that the rates of secondary resistance to clarithromycin were higher than primary resistance in the same population.

In Helicobacter pylori isolated from children, the frequent point mutations that are responsible for the clarithromycin resistance included A2143G, A2142G, A2142C and A2144G, and they varied geographically.

The doctors reported that comparing with culture-based susceptibility tests, stool PCR performed excellently for their rapidity, independence of bacterial growth, reproducibility and easy standardization.

However, stool PCR showed lower sensitivity but perfect specificity in detection of clarithromycin-resistant Helicobacter pylori in children.

The researchers assessed that methodology and mixed infections of resistant Helicobacter pylori strains might contribute to the considerable discrepancies of stool PCR results.

Dr Xiong's team concluded "Detection of clarithromycin-resistant Helicobacter pylori by stool PCR for children are reliable, rapid, noninvasive methods that are worthy of further clinical promotion."

"However, more evaluations of stool PCR in detection of clarithromycin-resistant Helicobacter pylori in children need to be conducted." 

Helicobacter 2013:18(2): 89-101
08 April 2013

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